1. Ultrasound-Assisted, Catheter-Directed Thrombolysis for Acute Intermediate/High-Risk Pulmonary Embolism: Design of the Multicenter USAT IH-PE Registry and Preliminary Results
- Author
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Claudia Colombo, Nicolò Capsoni, Filippo Russo, Mario Iannaccone, Marianna Adamo, Giovanna Viola, Ilaria Emanuela Bossi, Luca Villanova, Chiara Tognola, Camilla Curci, Francesco Morelli, Rossella Guerrieri, Lucia Occhi, Giuliano Chizzola, Antonio Rampoldi, Francesco Musca, Giuseppe De Nittis, Mario Galli, Giacomo Boccuzzi, Daniele Savio, Davide Bernasconi, Luciana D’Angelo, Andrea Garascia, Alaide Chieffo, Matteo Montorfano, Fabrizio Oliva, and Alice Sacco
- Subjects
pulmonary embolism ,ultrasound assisted ,catheter-directed thrombolysis ,pulmonary hypertension ,Medicine - Abstract
Catheter-based revascularization procedures were developed as an alternative to systemic thrombolysis for patients with intermediate-high- and high-risk pulmonary embolisms. USAT IH-PE is a retrospective and prospective multicenter registry of such patients treated with ultrasound-facilitated, catheter-directed thrombolysis, whose preliminary results are presented in this study. The primary endpoint was the incidence of pulmonary hypertension (PH) at follow-up. Secondary endpoints were short- and mid-term changes in the echocardiographic parameters of right ventricle (RV) function, in-hospital and all-cause mortality, and procedure-related bleeding events. Between March 2018 and July 2023, 102 patients were included. The majority were at intermediate–high-risk PE (86%), were mostly female (57%), and had a mean age of 63.7 ± 14.5 years, and 28.4% had active cancer. Echocardiographic follow-up was available for 70 patients, and in only one, the diagnosis of PH was confirmed by right heart catheterization, resulting in an incidence of 1.43% (CI 95%, 0.036–7.7). RV echocardiographic parameters improved both at 24 h and at follow-up. In-hospital mortality was 3.9% (CI 95%, 1.08–9.74), while all-cause mortality was 11% (CI 95%, 5.4–19.2). Only 12% had bleeding complications, of whom 4.9% were BARC ≥ 3. Preliminary results from the USAT IH-PE registry showed a low incidence of PH, improvement in RV function, and a safe profile.
- Published
- 2024
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